NPI 1174642136
Jesse Peterson, physical therapist
Physical Therapy Assistant · Chicago, IL
Active in the CMS NPI RegistryNot on the OIG exclusion listchecked Oct 15, 2026, 4:15 am EDT
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Jesse Peterson, physical therapist is a health care provider (Physical Therapy Assistant) in Chicago, Illinois with National Provider Identifier (NPI) 1174642136. The NPI was issued on Mar 28, 2007 and the registry record was last updated on Jul 8, 2007. The registry lists a license in Illinois.
Registry record
- NPI
- 1174642136
- Type
- Individual (NPI-1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- Practice location
- 222 S Riverside Plz Ste 830
Chicago, IL 60606-5900 - Phone
- (866) 386-0773
- NPI issued
- Mar 28, 2007
- Registry record updated
- Jul 8, 2007
Specialties and licenses
| Specialty | Taxonomy code | License state | License |
|---|---|---|---|
| Physical Therapy Assistant Primary | 225200000X | Illinois | 160003784 |
Confirm license status and discipline with the state board (links in NPI Lookup).
Physical Therapy Assistant providers in Illinois
- Emily Catherine Miller, PTACoal Valley, IL
Source: CMS National Plan and Provider Enumeration System (NPPES) and the HHS-OIG List of Excluded Individuals/Entities (list of Oct 9, 2026). Is this your record? Update it in NPPES or email info@2minutemedicine.com to have it hidden here.